SCORTEN in SJS/TEN: hypoalbuminaemia and oedema

Bunker, C.B.; Chapman, Anna

doi:10.1111/jdv.17136

Cited by 2 publications

(4 citation statements)

References 11 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with SJS/TEN usually present with internal organ damage and systemic bacterial infections, such as impaired renal function, pulmonary infections, liver injury, and hypoalbuminemia, which may indicate poor prognosis. 11 35 36 37 38 The results of this study showed that RDW-SD, Crea, AST, CRP, PCT were significantly higher and Alb was significantly lower in deceased patients compared to survivors. These indicators reflect the status of liver and kidney function, nutritional status, systemic bacterial infections, and inflammatory reactions to a certain extent.…”

Section: Discussionmentioning

confidence: 72%

RDW-SD and PCT Are Potential Prognostic Factors for In-hospital Death in Patients With Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

Zhang,

Lan,

et al. 2023

Allergy Asthma Immunol Res

View full text Add to dashboard Cite

Purpose Our study aimed to explore potential prognostic factors in Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) patients from easily accessible laboratory data and to investigate whether the combination of these indicators with a score for toxic epidermal necrolysis (SCORTEN) can improve the predictive value. Methods Data from 85 SJS/TEN patients hospitalized from 2010 to 2021 were retrospectively analyzed. The primary outcome was in-hospital mortality. Univariate analysis was used to screen for laboratory indexes associated with death. Logistic regression was used to analyze significant risk factors for death. The differentiation and calibration of SCORTEN and modified score were assessed using receiver operating characteristic (ROC) curves and Hosmer-Lemeshow goodness-of-fit test. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to evaluate the incremental prognostic value. Results Among the 85 patients (37 males, 48 females) aged 14-88 years, the mortality rate was 11.8% (n = 10). SCORTEN had good discrimination and calibration to predict mortality in this cohort of patients (area under the ROC curve [AUC] of 0.874, 95% confidence interval [CI], 0.758-0.990; Hosmer-Lemeshow goodness-of-fit test P = 0.994). Red cell distribution width-standard deviation index (RDW-SD) > 47.9 fL and procalcitonin (PCT) > 0.67 ng/mL were significant risk factors for death. When adding the 2 factors to SCORTEN, AUC was 0.915 (95% CI, 0.833–0.997), but not statistically different compared to SCORTEN alone ( P = 0.091). The NRI was 1.2 (95% CI, 0.672–1.728; P < 0.001) and the IDI was 0.09 (95% CI, 0.011–0.173; P = 0.026), still suggesting that the modified score had better discriminatory and predictive power than SCORTEN alone. The modified score also showed good calibration (Hosmer-Lemeshow goodness-of-fit test, P = 0.915). Conclusions SCORTEN is a good predictor of mortality in SJS/TEN patients in southwest China. Combining RDW-SD > 47.9 fL and PCT > 0.67 ng/mL with SCORTEN may enhance the ability to predict prognosis.

show abstract

Section: Discussionmentioning

confidence: 72%

RDW-SD and PCT Are Potential Prognostic Factors for In-hospital Death in Patients With Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

Zhang,

Lan,

et al. 2023

Allergy Asthma Immunol Res

View full text Add to dashboard Cite

show abstract

“…Moreover, research indicates that serum albumin <30 g/L may portend the fast deterioration and virulent exacerbation of the SJS/TEN hypersensitivity phenomena. Concurrently, the reduction of the albumin rate correlates with SJS/TEN severity 9 . RDW is an index that measures the change in red blood cell size or volume.…”

Section: Discussionmentioning

confidence: 99%

“…More importantly, these biomarkers, which have a strong association with systemic immunity, inflammation, and nutritional status, have been considered critical prognostic indicators for various malignant and severe diseases 6,8 . Current studies suggest that severe systemic inflammation and immune nutritional disorders are closely related to SJS/TEN prognosis 1,9 . Even so, the role of these biomarkers in predicting SJS/TEN severity and mortality is unclear.…”

Section: Introductionmentioning

confidence: 99%

“…6,8 Current studies suggest that severe systemic inflammation and immune nutritional disorders are closely related to SJS/TEN prognosis. 1,9 Even so, the role of these biomarkers in predicting SJS/TEN severity and mortality is unclear. Hence, this study aims to assess the clinical value of PNI and RAR in predicting SJS/TEN severity and mortality.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical value of the prognostic nutritional index and red blood cell distribution width‐to‐albumin ratio for the prediction of severity of and mortality associated with Stevens–Johnson syndrome/toxic epidermal necrolysis

Zhang

Jiang

et al. 2022

The Journal of Dermatology

View full text Add to dashboard Cite

The prognostic nutritional index (PNI) and red blood cell distribution width-to-albumin ratio (RAR) are considered to be related to the prognosis of disease severity. However, the role of these biomarkers in predicting Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) severity and mortality is unclear. The aim of the current study was to investigate the association of PNI and RAR with severity and mortality in individuals with SJS/TEN. Clinical data were retrospectively collected from 74 individuals with SJS/ TEN and 74 healthy individuals, who were matched for age and sex during the same period. PNI, RAR, and other indicators were compared between individuals with SJS/ TEN and healthy controls. The association of PNI and RAR with SJS/TEN severity was assessed using Spearman or Pearson correlation analyses. Individuals with SJS/TEN were categorized into two groups, either survivors or nonsurvivors. The correlation between PNI, RAR, and SJS/TEN mortality was analyzed using univariate and multivariate logistic regression. The predictive value of the previously mentioned indicators on the mortality of patients with SJS/TEN was assessed using receiver operating characteristic curve analysis. The RAR level of patients with SJS/TEN was greater than that of the control group (p < 0.05), whereas PNI was lower. In compliance with correlation analysis, RAR was positively correlated with SCORTEN (Score of Toxic Epidermal Necrolysis) and ABCD-10 (age, bicarbonate, cancer, dialysis, 10% body surface area) (p < 0.05), and PNI was negatively correlated (p < 0.05). RAR is a risk factor for death in patients with SJS/TEN, but an elevated PNI level is a protective factor for mortality. The best cutoff values of PNI and RAR for predicting death in patients with SJS/TEN were 31.375 (sensitivity, 84.7%; specificity, 80%) and 0.486 (sensitivity, 73.3%; specificity, 84.7%). These results underscore the potential clinical value of PNI and RAR as appropriate and meaningful biomarkers to assess the severity of SJS/TEN and the mortality associated with it.

show abstract

SCORTEN in SJS/TEN: hypoalbuminaemia and oedema

Cited by 2 publications

References 11 publications

RDW-SD and PCT Are Potential Prognostic Factors for In-hospital Death in Patients With Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

RDW-SD and PCT Are Potential Prognostic Factors for In-hospital Death in Patients With Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

Clinical value of the prognostic nutritional index and red blood cell distribution width‐to‐albumin ratio for the prediction of severity of and mortality associated with Stevens–Johnson syndrome/toxic epidermal necrolysis

Contact Info

Product

Resources

About